Catching Alzheimer's earliest symptoms may help delay disease

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Nov. 2, 2017, 12:24 PM GMT / Source: TODAY

By Robert Powell

Warning signs for Alzheimer’s disease can begin in the brain decades before memory loss or other symptoms appear, scientists now realize. That's why they're pushing for more early testing, in the hopes that early lifestyle changes can hold off the disease's destruction of the brain.

November is National Alzheimer's Disease Awareness Month and as part of the Brain Power TODAY series, NBC special anchor Maria Shriver met with neurosurgeon Dr. Keith Black of Cedars-Sinai Medical Center in Los Angeles who is developing a retinal scan that could detect early signs.

The scan, which Black hopes could become part of a typical eye exam, would spot plaques made of amyloid proteins in the brain. These plaques start to build up in the brain many years before patients are diagnosed with Alzheimer's. One of the earliest sites they accumulate is the retina.

Black, who is chairman of the Cedars-Sinai department of neurosurgery, has a vision of the future: “An inexpensive, widely available screening test that individuals in their 30s and 40s can do on a routine basis when they go to their ophthalmologist."

Another early sign may be changes in a person’s sense of smell. Researchers in Montreal have developed an experimental smell test to detect the disease.

“They can’t tell if it’s rose petals, strawberries, peanut butter, gasoline, you name it,” said Dr. John Breitner, the director of the Centre for Studies on Prevention of Alzheimer's Disease at the Douglas Mental Health University Institute at McGill University. “It turns out the disease attacks certain areas of the brain that have to do with the sense of smell.”

While those tests await the U.S. Food and Drug Administration's approval, it’s possible to spot some early changes that point to a diagnosis of Alzheimer’s. The Alzheimer's Association names 10 of the hallmark signs of the disease. For the full list of symptoms, go here

To slow Alzheimer’s progression or to improve brain health overall, research suggests four primary categories — physical health and exercise, diet and nutrition, cognitive activity and social engagement, according to the Alzheimer’s Association. “Research has suggested that combining good nutrition with mental, social and physical activities may have a greater benefit in maintaining or improving brain health than any single activity," said spokesperson Mike Lynch.

The best way to confirm that the signs you're seeing are indicative of Alzheimer’s is to locate a doctor with expertise in the disease, like Dr. Carolyn Kaloostian, an assistant professor of clinical family medicine and geriatrics at the Keck School of Medicine at the University of Southern California.

Unlike many generalists, Kaloostian checks all patients over age 64 for signs of Alzheimer’s. “We screen annually for cognitive decline early before there are symptoms so we can try to implement what we know will help slow the progression,” she said.

Kaloostian is unusual. According to the Gerontological Society, physicians miss the signs of cognitive impairment in over 40 percent of patients.

So it makes sense to find a doctor like Kaloostian who has expertise in catching the early signs of the disease. The Alzheimer's Association offers these tips for choosing a doctor to evaluate memory and thinking problems.